HomeMy WebLinkAboutExcavating Permit 16-G-06 f
"EXHIBIT A"
FOR CITY USE ONLY
4Frr.n5�1 PERMIT#
DATE
EXCAVATING & GRADING PERMIT -:ssurr) -,-�
Applicant: Q CSC?. C Phone:
Project/Development Name if Applicable:
Address: % /�� ��`7 &n-� �ic� f�i' /"z YYIIU x
Property Owner: _ Phone:
Address:
Contractor: Phone:
Address:
Consultant Engineer/Surveyor: Phone:
Address: i
Emergency Contact(24 HR): C, MM&,i Phone:
Location of the Property: 3Zk'_ OL-bove Q.jA!4o-e/JJ
Legal Description:
Will the excavation or filling be in a: Watercourse Wetland Upland
Purpose for the proposed excavating or.filling:. L �C)q em 'tt ✓P} '�� �cc
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Estimated start.date: — }- i Completio date:
What is the type of material to be removed or deposited? KQC.l.0 g
What is the quantity of material to be removed or deposited? S-7) C� t ickE,,
What is the total area disturbed for excavation or filling? `ib Cb �_ J_%
In what manner will the material be removed and/or deposited. ! r, --\-VUC '(
What highway,street or other public-way will material for removal or deposition be hauled'or carried?
What, if any,street, avenue, lane,alley, highway, right-of-way,thoroughfare or public ground will be obstructed? n A
ITSHALL BE THE RESPONSIBILITY AND THE BURDEN OF THE APPLICANTTO DEMONSTRATE TO THE SATISFACTION OF THE
CITY ENGINEER FOR THE CITY OF PRIOR LAKE THAT THE PROPOSED EXCAVATION AND/Oit FILLING COMPLIES WITH THE
OVERALL CITY OF PRIOR LAKE STORM WATER MANAGEMENT PLAN. SAID BURDEN SHALL INCLUDE THE FURNISHING OF
A REPORT WITH SUPPORTING CALCULATIONS OF A REGISTERED PROFESSIONAL ENGINEER.
Will proposed excavation or de si 'on aff he City of Prior Lake overall storm water management plan?Yes_ No x
If yes,explain proposed effec '